Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Intermountain Functional Medicine, PLLC

Organization Family Nurse Practitioner · NPI 1659719177

Intermountain Functional Medicine, PLLC is a Family Nurse Practitioner in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2013.

Licensed in
ID
In the registry since
2013
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

913 S Allante Pl
Boise, ID 83709-1612
Phone: (208) 947-5390
Fax: (208) 947-3465
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP816A (ID)

Record details

NPI number1659719177
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kathy Bowen — Sole Member · (208) 947-5390
NPI enumeratedJune 6, 2013
Last updated in NPPESJune 6, 2013
Mailing address13960 W Wainwright Dr, Boise, ID 83713-1969

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